The Peace Corps’ highest priority is maintaining the good health and safety of every Volunteer and trainee. Medical programs emphasize the preventive, rather than the curative approach to disease.

Serving as a Volunteer overseas entails certain safety and security risks. Living and traveling in an unfamiliar environment, a limited understanding of the local language and culture, and the perception of being a wealthy American are some of the factors that can put a Volunteer at risk.

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The Peace Corps’ highest priority is maintaining the good health and safety of every Volunteer. Peace Corps medical programs emphasize the preventive, rather than the curative, approach to disease. The Peace Corps in South Africa maintains a clinic with a full-time medical officer, who takes care of Volunteers’ primary healthcare needs. Additional medical services, such as testing and basic treatment, are also available in South Africa at local, American-standard hospitals. If you become seriously ill, you will be transported either to an American-standard medical facility in the region or to the United States.

Major health problems among Peace Corps Volunteers in South Africa are rare and are often the result of a Volunteer’s not taking preventive measure to stay healthy. The most common health problems here are minor ones also found in the United States, such as colds, diarrhea, skin infections, headaches, sinus infections, dental problems, minor injuries, STDs, adjustment disorders, and emotional problems. These problems may be compounded by living in another culture.

The most common health concerns here are malaria, HIV/AIDS, gastrointestinal infections, alcoholism, and skin disorders. Because malaria is endemic in parts of South Africa, you will be required to take antimalarial pills. You will also be vaccinated against hepatitis A and B, meningitis, tetanus, typhoid, and rabies.

Note that there are limited options for American-standard psychological counseling in South Africa, and no therapists are available for extended counseling services. Monitoring mental health conditions is difficult at best. There are Alcoholics Anonymous facilities in the larger cities, but there are no support groups in rural areas. Alcohol is an integral part of many social interactions in South Africa, and you may be pressured to drink even if you choose not to, as there is little understanding of alcoholism.

The Peace Corps will provide you with all the necessary inoculations, medications, and information to stay healthy. Upon your arrival in South Africa, you will receive a medical handbook. At the end of training, you will receive a medical kit with supplies to take care of mild illnesses and first-aid needs. The contents of the kit are listed later in this chapter.

During pre-service training, you will have access to basic medical supplies through the medical officer. However, you will be responsible for your own supply of prescription drugs and any other specific medical supplies you require, as we will not order these items during training. Please bring a three-month supply of any prescription drugs you use, since they may not be available here and it may take several months for new shipments to arrive.

You will have physicals at midservice and at the end of your service. If you develop a serious medical problem during your service, the medical officer in South Africa will consult with the Office of Medical Services in Washington, D.C. If it is determined that your condition cannot be treated in South Africa, you may be sent out of the country for further evaluation and care.

As a Volunteer, you must accept a certain amount of responsibility for your own health. Proper precautions will significantly reduce your risk of serious illness or injury. The old adage “An ounce of prevention …” becomes extremely important in areas where diagnostic and treatment facilities are not up to the standards of the United States. The most important of your responsibilities in South Africa is to take preventive measures for the following:

Malaria is hyperendemic and present in areas where Volunteers serve. It can kill you if left untreated, so prophylaxis against malaria is mandatory, and early recognition of infection is extremely important. Other preventive measures, such as the use of Peace Corps-issued mosquito nets, insect repellents, and screens on windows and doors, are strongly encouraged.

Rabies is prevalent throughout the country, so you will receive a series of immunizations against it during your training period. If you are exposed to an animal that is known or suspected to have rabies, you must inform the medical officer at once so that you can receive post-exposure booster shots.

Many illnesses that afflict Volunteers worldwide are entirely preventable if proper food and water precautions are taken. These illnesses include food poisoning, parasitic infections, hepatitis A, dysentery, Guinea worms, tapeworms, and typhoid fever. Your medical officer will discuss specific standards for water and food preparation in South Africa during pre-service training.

Abstinence is the only certain choice for preventing infection with HIV and other STDs. You are taking risks if you choose to be sexually active. To lessen risk, use a condom every time you have sex. Whether your partner is a host country citizen, a fellow Volunteer, or anyone else, do not assume this person is free of HIV/AIDS or other STDs. You will receive more information from your medical officer about this important issue.

Volunteers are expected to adhere to an effective means of birth control to prevent an unplanned pregnancy. Your medical officer can help you decide on the most appropriate method to suit your individual needs. Contraceptive methods are available without charge from the medical officer.

It is critical to your health that you promptly report to the medical office or other designated facility for scheduled immunizations, and that you let your medical officer know immediately of significant illnesses and injuries.

Pregnancy is treated in the same manner as other Volunteer health conditions requiring medical attention but may also have programmatic ramifications. The Peace Corps is responsible for determining the medical risk and the availability of appropriate medical care if the Volunteer remains in-country. Given the circumstances under which Volunteers live and work in Peace Corps countries, it is rare that the Peace Corps medical and programmatic standards for continued service can be met. The majority of Volunteers who become pregnant are medically separated.

If feminine hygiene products are not available for you to purchase on the local market, the Peace Corps medical officer in South Africa will provide them. If you require a specific product, please bring a six-month supply with you.

The Peace Corps medical officer provides Volunteers with a first-aid kit that contains basic items necessary to prevent and treat illnesses that may occur during service. Kit items can be periodically restocked at the medical office.

If there has been any change in your health—physical, mental, or dental—since you submitted your examination reports to the Peace Corps, you must immediately notify the Office of Medical Services. Failure to disclose new illnesses, injuries, allergies, or pregnancy can endanger your health and may jeopardize your eligibility to serve.

If your dental exam was done more than a year ago, or if your physical exam is more than two years old, contact the Office of Medical Services to find out whether you need to update your records. If your dentist or Peace Corps dental consultant has recommended that you undergo dental treatment or repair, you must complete that work and make sure your dentist sends requested confirmation reports or X-rays to the Office of Medical Services.

If you wish to avoid having duplicate vaccinations, you should contact your physician’s office, obtain a copy of your immunization record, and bring it to your pre-departure orientation. If you have any immunizations prior to Peace Corps service, the Peace Corps cannot reimburse you for the cost. The Peace Corps will provide all the immunizations necessary for your overseas assignment, either at your predeparture orientation or shortly after you arrive in South Africa. You do not need to begin taking malaria medication prior to departure. Bring a three-month supply of any prescription or over-thecounter medication you use on a regular basis, including birth control pills. Although the Peace Corps cannot reimburse you for this three-month supply, we will order refills during your service. While awaiting shipment—which can take several months—you will be dependent on your own medication supply. The Peace Corps will not pay for herbal or nonprescribed medications, such as St. John’s wort, glucosamine, selenium, or antioxidant supplements.

You are encouraged to bring copies of medical prescriptions signed by your physician. This is not a requirement, but they might come in handy if you are questioned in transit about carrying a three-month supply of prescription drugs.

If you wear eyeglasses, bring two pairs with you—a pair and a spare. If a pair breaks, the Peace Corps will replace it, using the information your doctor in the United States provided on the eyeglasses form during your examination. We discourage you from using contact lenses during your Peace Corps service to reduce your risk of developing a serious infection or other eye disease. Most Peace Corps countries do not have appropriate water and sanitation to support eye care with the use of contact lenses. The Peace Corps will not supply or replace contact lenses or associated solutions unless their use has been recommended by an ophthalmologist for a specific medical condition and the Peace Corps’ Office of Medical Services has given approval.

If you are eligible for Medicare, are over 50 years of age, or have a health condition that may restrict your future participation in healthcare plans, you may wish to consult an insurance specialist about unique coverage needs before your departure. The Peace Corps will provide all necessary healthcare from the time you leave for your pre-departure orientation until you complete your service. When you finish, you will be entitled to the post-service healthcare benefits described in the Peace Corps Volunteer Handbook. You may wish to consider keeping an existing health plan in effect during your service if you think age and/or preexisting conditions might prevent you from reenrolling in your current plan when you return home.

Serving as a Volunteer overseas entails certain safety and security risks. Living and traveling in an unfamiliar environment, a limited understanding of the local language and culture, and the perception of being a wealthy American are some of the factors that can put a Volunteer at risk. Property thefts and burglaries are not uncommon. Incidents of physical and sexual assault do occur, although almost all Volunteers complete their two years of service without serious personal safety problems. In addition, more than 84 percent of Volunteers surveyed in the 2004 Peace Corps Volunteer Survey say they would join the Peace Corps again.

The Peace Corps approaches safety and security as a partnership with you. This Welcome Book contains sections on: Living Conditions and Volunteer Lifestyle; Peace Corps Training; and Your Health Care and Safety. All of these sections include important safety and security information.

The Peace Corps makes every effort to give Volunteers the tools they need to function in the safest and most secure way possible, because working to maximize the safety and security of Volunteers is our highest priority. Not only do we provide you with training and tools to prepare for the unexpected, but we teach you to identify and manage the risks you may encounter.

There are several factors that can heighten a Volunteer’s risk, many of which are within the Volunteer’s control.

Based on information gathered from incident reports worldwide in 2004, the following factors stand out as risk characteristics for assaults. Assaults consist of personal crimes committed against Volunteers, and do not include property crimes (such as vandalism or theft).

Location: Most crimes occurred when Volunteers were in public areas (e.g., street, park, beach, public buildings). Specifically, 43 percent of assaults took place when Volunteers were away from their sites.

Time of day: Assaults usually took place on the weekend during the evening between 5:00 p.m. and 2:00 a.m.— with most assaults occurring around 1:00 a.m.

Absence of others: Assaults ususally occurred when the Volunteer was unaccompanied. In 82 percent of the sexual assaults the Volunteer was unaccompannied and in 55 percent of physical assaults the Volunteer was unaccompanied.

Relationship to assailant: In most assaults, the Volunteer did not know the assailant.

In March 2003, the Peace Corps created the Office of Safety and Security with its mission to “foster improved communication, coordination, oversight, and accountability of all Peace Corps’ safety and security efforts.” The new office is led by an Associate Director for Safety and Security who reports to the Peace Corps Director and includes the following divisions: Volunteer Safety and Overseas Security;

The major responsibilities of the Volunteer Safety and Overseas Security Division are to coordinate the office’s overseas operations and direct the Peace Corps’ safety and security officers who are located in various regions around the world that have Peace Corps programs. The safety and security officers conduct security assessments; review safety trainings; train trainers and managers; train Volunteer safety wardens, local guards, and staff; develop security incident response procedures; and provide crisis management support.

If a trainee or Volunteer is the victim of a safety incident, Peace Corps staff is prepared to provide support. All Peace Corps posts have procedures in place to respond to incidents of crime committed against Volunteers. The first priority for all posts in the aftermath of an incident is to ensure that the Volunteer is safe and receiving medical treatment as needed. After assuring the safety of the Volunteer, Peace Corps staff provide support by reassessing the Volunteer’s work site and housing arrangements and making any adjustments, as needed. In some cases, the nature of the incident may necessitate a site or housing transfer. Peace Corps staff will also assist Volunteers with preserving their rights to pursue legal sanctions against the perpetrators of the crime. It is very important that Volunteers report incidents as they occur, not only to protect their peer Volunteers, but also to preserve the future right to prosecute. Should Volunteers decide later in the process that they want to proceed with the prosecution of their assailant, this option may no longer exist if the evidence of the event has not been preserved at the time of the incident.

The country-specific data chart below shows the incidence rates and the average number of incidents of the major types of safety incidents reported by Peace Corps Volunteers/trainees in South Africa as compared to all other Africa region programs as a whole, from 2000–2004. It is presented to you in a somewhat technical manner for statistical accuracy.

To fully appreciate the collected data below, an explanation of the graph is provided as follows:

The incidence rate for each type of crime is the number of crime events relative to the Volunteer/trainee population. It is expressed on the chart as a ratio of crime to Volunteer and trainee years (or V/T years, which is a measure of 12 full months of V/T service) to allow for a statistically valid way to compare crime data across countries. An “incident” is a specific offense, per Peace Corps’ classification of offenses, and may involve one or more Volunteer/trainee victims. For example, if two Volunteers are robbed at the same time and place, this is classified as one robbery incident.

The chart is separated into eight crime categories. These include vandalism (malicious defacement or damage of property); theft (taking without force or illegal entry); burglary (forcible entry of a residence); robbery (taking something by force); minor physical assault (attacking without a weapon with minor injuries); minor sexual assault (fondling, groping, etc.); aggravated assault (attacking with a weapon, and/or without a weapon when serious injury results); and rape (sexual intercourse without consent).

When anticipating Peace Corps Volunteer service, you should review all of the safety and security information provided to you, including the strategies to reduce risk. Throughout your training and Volunteer service, you will be expected to successfully complete all training competencies in a variety of areas including safety and security. Once in-country, use the tools and information shared with you to remain as safe and secure as possible.

When it comes to your safety and security in the Peace Corps, you have to be willing to adapt your behavior and lifestyle to minimize the potential for being a target of crime. As with anywhere in the world, crime does exist in South Africa. You can reduce your risk by avoiding situations that make you feel uncomfortable and by taking precautions. Crime at the village or town level is less frequent than in the large cities; people know each other and generally will not steal from their neighbors. Tourist attractions, especially in large towns, are favorite work sites for pickpockets. The following are safety concerns in South Africa you should be aware of:

Motor vehicle accidents. Speed, unsafe vehicles, alcohol, and road rage contribute to most traffic fatalities. Volunteers are strongly encouraged to wear seat belts when available. Using public buses and vans is difficult to avoid, and they tend to be overcrowded. Vehicles are often not up to Western safety standards, and driving under the influence is a common problem. Traveling after dark is discouraged.

Robbery/burglary. The homes of some Volunteers have been robbed in the past, but most robberies, muggings, and thefts have occurred in towns and large cities. Therefore, it is important to exercise caution at all times. The Peace Corps requires host families to install burglar bars and locks in all Volunteers’ homes. We will advise you on proper home safety during training.

Harassment. Volunteers have reported varying levels of harassment over money, age, gender, racial or ethnic background, religious beliefs, and sex or sexual orientation. This can happen anywhere—at work, at one’s site, in towns, or while traveling on public transportation. Strategies for dealing and coping with harassment are discussed extensively during training.

Alcohol abuse. South Africa has a higher rate of alcoholism than the United States does, and Volunteers have reported being approached by intoxicated people asking for money, sex, and/or alcohol. It is best to avoid bars and other places that sell alcohol, particularly at night. Volunteers must act responsibly with regard to their own alcohol consumption to preserve their reputation and working relationships in the community.

Sexual assault. Volunteers in South Africa have been targets of sexual assault. Cross-cultural differences in gender relations and alcohol consumption are often associated with sexual assaults. Sexual assault will be addressed in pre-service training. Volunteers are strongly urged to report all assaults or threats of assault to the Peace Corps medical officer or other staff so that they can respond with appropriate support.

Note that sex outside of marriage is not looked on favorably in South Africa and may jeopardize your safety or your ability to develop mutually respectful relationships in your community and at your job. South Africans often hold Volunteers to a different standard of sexual morality than they hold themselves to. Also note that promiscuity puts both men and women at risk for STDs, particularly HIV/AIDS.

Gay, lesbian, and bisexual Volunteers will have to practice discretion. Some South Africans are homophobic, and there have been instances of violence toward individuals who are presumed to be or who are openly gay. The Peace Corps is committed to providing support for all Volunteers regardless of sexual orientation.

You must be prepared to take on a large degree of responsibility for your own safety. Only you can make yourself less of a target, ensure that your house is secure, and develop relations in your community that will make you an unlikely victim of crime. In coming to South Africa, do what you would do if you moved to a large city in the United States: Be cautious, check things out, ask questions, learn about your neighborhood, know where the more risky locations are, use common sense, and be aware. You can reduce your vulnerability to crime by integrating into your community, learning the local language, acting responsibly, and abiding by Peace Corps policies and procedures. Serving safely and effectively in South Africa may require that you accept some restrictions on your current lifestyle.

Volunteers attract a lot of attention in large cities and at their sites, but receive far more negative attention in highly populated centers, where they are anonymous, than in smaller towns, where “family,” friends, and colleagues look out for them. While whistles and exclamations are fairly common on the street, this behavior can be reduced if you dress conservatively, avoid eye contact, and do not respond to unwanted attention. Keep your money out of sight by using an undergarment money pouch, the kind that hangs around your neck and stays hidden under your shirt or inside your coat.

Do not keep your money in outside pockets of backpacks, in coat pockets, or in fanny packs. You should always walk with a companion at night.

Preparing for the Unexpected: Safety Training and Volunteer Support in South Africa[edit]

The Peace Corps’ approach to safety is a five-pronged plan to help you stay safe during your two-year service and includes the following: information sharing, Volunteer training, site selection criteria, a detailed emergency action plan, and protocols for addressing safety and security incidents. South Africa’s in-country safety program is outlined below.

The Peace Corps/South Africa office will keep Volunteers informed of any issues that may impact Volunteer safety through information sharing. Regular updates will be provided in Volunteer newsletters and in memorandums from the country director. In the event of a critical situation or emergency, Volunteers will be contacted through the emergency communication network.

Volunteer training will include sessions to prepare you for specific safety and security issues in South Africa. This training will prepare you to adopt a culturally appropriate lifestyle and exercise judgment that promotes safety and reduces risk in your home, at work, and while traveling. Safety training is offered throughout your two-year service and is integrated into the language, cross-cultural, health, and other components of training.

Certain site selection criteria are used to determine safe housing for Volunteers before their arrival. The Peace Corps staff works closely with host communities and counterpart agencies to help prepare them for a Volunteer’s arrival and to establish expectations of their respective roles in supporting the Volunteer. Each site is inspected before the Volunteer’s arrival to ensure placement in appropriate, safe, and secure housing and work sites. Site selection criteria are based in part on any relevant site history; access to medical, banking, postal, and other essential services; availability of communications, transportation, and markets; different housing options and living arrangements; and other support needs.

You will also learn about the country’s detailed emergency action plan in the event of civil or political unrest or a natural disaster. When you arrive at your site, you will complete and submit a site locator form with your address, contact information, and a map to your house. If there is a security threat, Volunteers in South Africa will gather at predetermined locations until the situation resolves itself or the Peace Corps decides to evacuate.

Finally, in order for the Peace Corps to be fully responsive to the needs of Volunteers, it is imperative that Volunteers immediately report any security incident to the Peace Corps medical officer. The Peace Corps has established protocols for addressing safety and security incidents in a timely and appropriate manner, and it collects and evaluates safety and security data to track trends and develop strategies to minimize risks to future Volunteers.